Shifting Toward Prevention: The Association between Family First Prevention Services Act Plan Approval and Child Maltreatment

Background/purpose.

Child maltreatment (CM) is a pervasive public health and social problem with long-term consequences for children’s physical health, mental well-being, cognitive development, and life course trajectories. Its effects extend beyond individuals, contributing to intergenerational cycles of trauma and increasing the risk of other forms of violence, such as intimate partner violence (IPV). Given these wide-ranging harms, effective CM prevention is both critical and urgent.

Historically, the U.S. child welfare system has relied heavily on reactive approaches, such as child protective services (CPS), which primarily intervene after maltreatment occurs. While CPS can play a protective role, its punitive orientation and reliance on out-of-home placements can lead to stigma, instability, and secondary trauma, especially for children placed in foster or congregate care settings.

In response, the Family First Prevention Services Act (FFPSA) was enacted in 2018 to shift the child welfare system toward prevention. FFPSA allows states to access federal funds for evidence-based services that aim to prevent foster care entry, reduce group care placements, support kinship caregivers, and expand services that address known risk factors for child maltreatment, such as substance use and mental health challenges.

States have discretion in how and when to implement FFPSA, resulting in variation in plan approval timing. This study leverages that variation to examine changes in CM outcomes before and after plan approval within states.

Using data from the National Child Abuse and Neglect Data System (NCANDS) from 2018 to 2023, this study examines two research questions: (1) Is FFPSA plan approval associated with a reduction in CPS referral cases within states? (2) Is FFPSA plan approval associated with a reduction in substantiated child maltreatment cases within states?

We hypothesize that states approving FFPSA plans will experience reductions in both CPS referrals and substantiated maltreatment cases over time.

Methods.

We conducted a longitudinal policy analysis using 1,191 observations from the National Child Abuse and Neglect Data System (NCANDS) between and 2023. Outcomes included (1) substantiated CM cases and (2) CPS referrals. FFPSA approval was coded as a binary indicator by state and quarter based on federal approval dates. We conducted two-way fixed effects generalized linear models with a Gaussian distribution and identity link. All models included state and quarter fixed effects, with standard errors clustered by state. Analyses were conducted in Stata.

Results.

FFPSA plan approval was significantly associated with reductions in both outcomes. On average, states experienced approximately 297 fewer CPS referrals and 59 fewer substantiated CM cases per quarter after plan approval.

Conclusions and Implications.

These findings suggest that FFPSA as a federal prevention-focused policy shows promise in reducing child welfare system involvement, and supports the shift away from reactive responses toward prevention and family-centered approaches. Given states’ flexibility in FFPSA implementation, these average effects may mask variation. Future research should explore state-level differences to better understand which strategies are more effective and sustainable.